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Dec 14, 2012 6:00am EST
on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose their business. mr. smith, are you aware of this provision? >> i am not familiar with that section. >> let me ask you this. in this provision, you may not know this either, but the word quality is not defined in the statute. it is safe to assume that the secretary, not just secretary sebelius, but every secretary to follow, would be able to define for regulation what that word quality means. yes or no? >> i believe that is the correct interpretation. again, we have tried to introduce quality performances into a variety of parts of our programs, both in managed care, both in the fee-for-service world, and this is another one of our concerns that we
Dec 13, 2012 8:00pm EST
a loss so vast. the aca is not just above the expansion of medicaid or establishing an insurance exchange, it is about the hundreds of federal mandates and procedural requirements that have the escaped public attention, but to which we by law must obey. the fine print of the legislation is so complex, even the federal government struggles to understand it. the states cannot fully understand the impact on finances, systems changes, and operations. this law completely overwhelms society's safety net for the needy. there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will
Dec 14, 2012 1:00am EST
that must be covered by any health plan offering a plan in the aca exchange. i understand this has far reaching consequences on premiums. benefits must be provided. according to the notice in the federal register, the rule was approved by administrator on august 1, 2012. that is three months before. yet the role did not receive approval from secretary sebillius until two weeks ago. what did it take two month for the administration staff to review -- and yet the public will have only four weeks to review during the period of public comment on the ruling issued on november 26? i would note this is a time of year when people's focus is generally on things other than long awaited rules. >> we put a bulletin on the essential health benefits quite some time ago and got comments on the bulletin. the public had an opportunity to provide public comment on essential health benefits before the proposed rule was put out. there were some changes from what had been in the bulletin, but by and large what is in the bulletin is what is a in the proposed rule. i think there has been ample opportunity fo
Dec 20, 2012 7:00pm EST
'll see a cut to health care. the -- plan to actually put the aca into place simply cannot go through with this plan. so we're talking about real cuts to folks' real lives. that's an important point of what's going on. >> fair enough. really more down the road. you heard ben jealous worry about that. let me just ask you -- >> the aca is going to raise health care costs monumentally. >> that's not a budget -- >> yes it is. >> reduce costs for consumers and cut the budget deficit by 1 $180 billion. what's the base of your projection? you're pulling it out of the air. >> no, i'm not. the congressional budget office keeps making costs increase from what they originally projected. now that various individual plans and firms are costing out what they're going to have to do, you're saying far more firms are going to be not covering people. this plan was conceived in a way that didn't understand the economic consequences. >> just to the clarify, the aca, obama care. >> yes. the affordable care act. >> basically protects -- >> anything but protect patients or be affordable. it is orwellian. >
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Dec 3, 2012 9:20am EST
. the attention now needs to be on medicare inside the aca. there were large structural reforms in the way healthcare was playing out. in fact, last year, we had a slower rate of growth and health care spending that we have had in quite a time. whether president has proposed is part of the current negotiations is another $300 billion cut in medicare. stuart: that is a cut. you do understand, that what we really -- >> stuart, that just is not true. we have not seen them play out. certainly, we will have to be coming back every year. usually, through a committee process where people vote at the end of the day. the republicans decided to take another course around the debt ceiling. i do not agree with you. i think to say otherwise is unfair to the president. stuart: i will have the last word. he is a hypocrite. let's not get into it now. you study up on that one, young simon. thank you very much. several states want longer school days. surprise, surprise, the unions are against it. that is next. ♪ only gaviscon® forms a protective barrier that helps block stomach acid from splashing up- re
Dec 17, 2012 12:00pm EST
will get even higher. >> but that is the point now that you have the aca that you can have this discussion in a way that was much harder to have before. it is really saying for those who are able to continue working, can we begin to reorient the expectation for the next generation, which is what we're talking about, recognizing that for people who are in that pre now pre-medicare age, they will no longer have to postpone taking care of health care because they, in fact, have an option. so it is why this discussion takes on a whole different tone as a result of the affordable care act having passed. >> i mean, i would say we have options, but we don't know if they're affordable options, and that's really the big difference. >> al milliken, am media. what can we learn from other countries? i'm wondering if any of you have studied the health benefit programs elsewhere, and do any have comparable insurance programs, and what has been the experience in other nations? >> most of them are struggling mightily with the promises they have made which encourage people to retire even earlier than they
Search Results 0 to 5 of about 6